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Cause of fatigue. Can you figure this out?
Hello,
I have family history of fatigue problems, and two with thyroid problems. The mental/physical/emotional fatigue seems to have been with me since I was a kid, with some depression in there, too, (possibly part of whatever is causing the fatigue), and the fatigue worsened in my teens when the stress and issues in my life were horrible.
I had hair mineral testing about 10 years ago and it said I had adrenal exhaustion in the last stage. I had cortisol testing with an MD a few years prior that mentioned something about my cortisol being on the lower side. That doctor thought my issue was Chronic Fatigue Syndrome, but I'm not convinced as it hasn't been proven with a test or anything. I'm not happy to just get a label.
This year, I had a yearly blood work check-up, and there was a mild Vit D deficiency. At one point, my TSH was out-of-range a little in hypo, but on retesting, it returned to normal.
I'm one that is on the sensitive side, and I didn't learn a lot of life lessons, and coping skills, so I'm more vulnerable to stress, even a little, especially emotional. I'm living a very calm, joyful life now. Yet, the fatigue continues.
***My main problems are: 1) the mental fatigue (with poor attention, memory, concentration, retention, etc.) with ADHD and other learning disabilities. 2) Physical fatigue (feeling "lazy," poor motivation, easily winded-feeling, need to sleep long hours, naps, etc.) 3) Easily stressed, affecting mental/emotional/physical
I've been trying Magnesium for a few weeks now and I haven't noticed any improvement yet.
***The VERY VERY interesting thing is that the only thing that I've ever used that has helped me alert-energy, motivation, and attention is Vyvanse, an ADHD medicine. I can avoid naps on this, at a low dose! I don't feel caffeinated, just some normal energy. I believe this works on the adrenals, stimulating them, so I suspect my issue is with my adrenals.
I read from Alternative Doctors that underneath ADHD, CFS, panic, etc. is an adrenal issue, and that after the issue is treated, the problems lessen or go away.
I'm considering seeing a good ND and getting everything checked out. I suspect they'll look into my nutritional levels and hormonal.
Any ideas on root of these issues?
I have family history of fatigue problems, and two with thyroid problems. The mental/physical/emotional fatigue seems to have been with me since I was a kid, with some depression in there, too, (possibly part of whatever is causing the fatigue), and the fatigue worsened in my teens when the stress and issues in my life were horrible.
I had hair mineral testing about 10 years ago and it said I had adrenal exhaustion in the last stage. I had cortisol testing with an MD a few years prior that mentioned something about my cortisol being on the lower side. That doctor thought my issue was Chronic Fatigue Syndrome, but I'm not convinced as it hasn't been proven with a test or anything. I'm not happy to just get a label.
This year, I had a yearly blood work check-up, and there was a mild Vit D deficiency. At one point, my TSH was out-of-range a little in hypo, but on retesting, it returned to normal.
I'm one that is on the sensitive side, and I didn't learn a lot of life lessons, and coping skills, so I'm more vulnerable to stress, even a little, especially emotional. I'm living a very calm, joyful life now. Yet, the fatigue continues.
***My main problems are: 1) the mental fatigue (with poor attention, memory, concentration, retention, etc.) with ADHD and other learning disabilities. 2) Physical fatigue (feeling "lazy," poor motivation, easily winded-feeling, need to sleep long hours, naps, etc.) 3) Easily stressed, affecting mental/emotional/physical
I've been trying Magnesium for a few weeks now and I haven't noticed any improvement yet.
***The VERY VERY interesting thing is that the only thing that I've ever used that has helped me alert-energy, motivation, and attention is Vyvanse, an ADHD medicine. I can avoid naps on this, at a low dose! I don't feel caffeinated, just some normal energy. I believe this works on the adrenals, stimulating them, so I suspect my issue is with my adrenals.
I read from Alternative Doctors that underneath ADHD, CFS, panic, etc. is an adrenal issue, and that after the issue is treated, the problems lessen or go away.
I'm considering seeing a good ND and getting everything checked out. I suspect they'll look into my nutritional levels and hormonal.
Any ideas on root of these issues?
Also...
I did a little reading on the Catecholamine test and it seems to just detect adrenal tumors. I don't see how that's helpful?
The "insulin-induced hypoglycemia test" looks good.
I did a little reading on the Catecholamine test and it seems to just detect adrenal tumors. I don't see how that's helpful?
The "insulin-induced hypoglycemia test" looks good.
Sorry! My bad! Had a brain dead day! I meant Catecholamines ! It is the corticosteroids used in therapy. I was getting ahead of myself!
I can't seem to find anything online about "corticosteroid" blood tests; only corticosteroid therapy.
Yes, I've used a few different labs.
It goes like this:
8-21-10:
Free T4 1.13 ng/dL [ref 0.60-2.19]
I think 3-29-10:
Free T4 1.18 ng/dL [ref I think ... 0.60-2.19]
October 2009:
Free T4 0.9 [ref 0.54-1.60 ng/dL] <<Very stressed and in the hospital for something.
__________________
They got my CPAP pressure to where I have zero apnea episodes. It's a very low pressure of 7, I believe. I still have awakenings, of which a cause couldn't be determined. I've been having the irritation/pain on my nose from the mask, too, and I solved it using moleskin on that area each night.
___________________
As for adrenal testing...
Does testing with a Naturopath fair better than with an MD?
Is there much difference between what is looked at in the 24 hour urine VS. 24 hour blood?
I just read results from someone that had the 24 hour urine and it tested:
DHEA
Testosterone
5a-Androstanediol
5b-Androstanediol
Androsterone
Etiocholanolone
Pregnanetriol
Cortisone (E)
Cortical (F)
Tetra hydrocortisone (THE)
Allo-Tetra hydrocortisol (5a-THF)
Tetra hydrocortisol (THF)
11B- Hydroxyandrosterone
11B- Hydroxyetiocholanolone
Aldosterone
Allo-tetrahydrocorticosterone (5a-THB)
Tetrahydrocorticosterone (THB)
11-Dehydrotetrahydrocorticosterone (THA)
HGH
Is that all that is tested?
What about the ACTH Stimulation test. What all is looked at with this and is it done out-patient?
Of the 24 hour urine, 24 hour blood, ACTH stimulation, and corticosteroids, which of these should I try and why? I was thinking about the 24 hour blood AND the ACTH. But I'm new to the latter one you mentioned. I'll have to do some reading. I agree about the cortisol one not being very helpful; that's the only one I've had, as far as I can recall.
What does one have to say to get their doctor to order these?
Would you have to have each written on individual lab sheets, or can they be on one lab sheet, but performed on different days?
Thank you sooooo much. :)
It goes like this:
8-21-10:
Free T4 1.13 ng/dL [ref 0.60-2.19]
I think 3-29-10:
Free T4 1.18 ng/dL [ref I think ... 0.60-2.19]
October 2009:
Free T4 0.9 [ref 0.54-1.60 ng/dL] <<Very stressed and in the hospital for something.
__________________
They got my CPAP pressure to where I have zero apnea episodes. It's a very low pressure of 7, I believe. I still have awakenings, of which a cause couldn't be determined. I've been having the irritation/pain on my nose from the mask, too, and I solved it using moleskin on that area each night.
___________________
As for adrenal testing...
Does testing with a Naturopath fair better than with an MD?
Is there much difference between what is looked at in the 24 hour urine VS. 24 hour blood?
I just read results from someone that had the 24 hour urine and it tested:
DHEA
Testosterone
5a-Androstanediol
5b-Androstanediol
Androsterone
Etiocholanolone
Pregnanetriol
Cortisone (E)
Cortical (F)
Tetra hydrocortisone (THE)
Allo-Tetra hydrocortisol (5a-THF)
Tetra hydrocortisol (THF)
11B- Hydroxyandrosterone
11B- Hydroxyetiocholanolone
Aldosterone
Allo-tetrahydrocorticosterone (5a-THB)
Tetrahydrocorticosterone (THB)
11-Dehydrotetrahydrocorticosterone (THA)
HGH
Is that all that is tested?
What about the ACTH Stimulation test. What all is looked at with this and is it done out-patient?
Of the 24 hour urine, 24 hour blood, ACTH stimulation, and corticosteroids, which of these should I try and why? I was thinking about the 24 hour blood AND the ACTH. But I'm new to the latter one you mentioned. I'll have to do some reading. I agree about the cortisol one not being very helpful; that's the only one I've had, as far as I can recall.
What does one have to say to get their doctor to order these?
Would you have to have each written on individual lab sheets, or can they be on one lab sheet, but performed on different days?
Thank you sooooo much. :)
The cortisol tests can be done in two ways, but the BEST way is to make sure they do a 24 hour collection in seperate samples. Meaning if they do the 24 hour sample in the same jug it mixes both morning and night cortisol and they give an average, not a true reading and many doctors fail to recognise this.
The other one is two blood draws, One at 8am and the other usually 4 or 5pm.
Neither of these involve a hospital stay.
You should ask for the corticosteroids test rather than just cortisol, as it is the former which the adrenals can lack if you have insufficiency or Addison's disease.
DHEA can be checked at the same time.
Give the CPAP time, you might need adjustments made to the volume of air pressure. I had mine for 3 months, found it wonderful, but couldn't get the mask to stop rubbing on the bridge of my nose and got an ulcer there. Due to a deformity in my nostrils, I can't use the nasal prong type either. One thing I did notice with it was though, that after 4 hours the air pressure would kind of explode through the back of my throat and I ended up snoring anyway. We tried all different pressures, but it seems I have a deformity in the nasal/throat area. You might like to have a look at Dr Stephen Parks site on the web. He is fantastic regarding sleep apneoa and CPAP information.
I suspect you had different labs do the thryoid tests, hence the different reference ranges?
The other one is two blood draws, One at 8am and the other usually 4 or 5pm.
Neither of these involve a hospital stay.
You should ask for the corticosteroids test rather than just cortisol, as it is the former which the adrenals can lack if you have insufficiency or Addison's disease.
DHEA can be checked at the same time.
Give the CPAP time, you might need adjustments made to the volume of air pressure. I had mine for 3 months, found it wonderful, but couldn't get the mask to stop rubbing on the bridge of my nose and got an ulcer there. Due to a deformity in my nostrils, I can't use the nasal prong type either. One thing I did notice with it was though, that after 4 hours the air pressure would kind of explode through the back of my throat and I ended up snoring anyway. We tried all different pressures, but it seems I have a deformity in the nasal/throat area. You might like to have a look at Dr Stephen Parks site on the web. He is fantastic regarding sleep apneoa and CPAP information.
I suspect you had different labs do the thryoid tests, hence the different reference ranges?
I think this is the latest Free T3:
TSH 2.53 uIu/mL
T3 Total 136 ng/dL [ref 76-181 ng/dL]
>>T3 Free 335 pg/dL [ref 230-420 pg/dL]
Free T4 1.18 ng/dL
Thy Perox AB TPO 11 IU/mL [ref <35 IU/mL]
http://www.medhelp.org/posts/Thyroid-Disorders/New-lab-results-from-3-29-10/show/1213480
----------------
October 2009:
Free T4 0.9
Free T3 3.3
T3 Uptake 36.1
TSH 1.39
Random cortisol 12.4
ref:
Free T3: 2.5-3.9 pg/mL
Free T4: 0.54-1.60 ng/dL
TSH: 0.34-5.60 uIU/mL
T3 Uptake: 32-48 %
Random Cortisol: Morning (AM) = 4.3-22.4 ug/dL
Afternoon (PM) = 3.1-16.7 ug/dL
------------------------------------
I looked and cannot find that FT3 result. Since your FT4 is well below midpoint of the range you posted for it, I'll be surprised if your FT3 is any higher in its range. Could you please post the FT3 again? If it is also in the lower part of its range, those results would be consistent with hypothyroidism. Not saying that you may not have other problems, but I'd really like to Assess the thyroid tests again.
Thank you to both of you.
My calcium level was checked several months ago, but I think it was the usual serum test. I recently had my RBC Magnesium checked, and it was low-normal. I've been taking magesium taurate for several weeks, and I haven't noticed any kind of improvements yet.
I was found to have a very mild Vitamin D deficiency. Some use of Vit D supplement didn't seem to do anything.
I was recently diagnosed with "Upper Airway Resistance" form of sleep apnea, with a very mild severity. I'm on a trial of CPAP, and I haven't noticed any improvements yet.
I've gone through many kinds of special food diets, including one that cut out things I tested allergic to, though they weren't causing symptoms; as well as a sugar-free diet; a candida diet (in case I had it); high vegetable diet with raw juicing; etc. They didn't seem to improve my health.
I posted my FT3 on here before, and everyone was saying my levels were right where they should be, so I began looking elsewhere. Though if the ND I'm considering seeing advises I try a thyroid product, I'll try it for sure.
What kind of tests are there for adrenal testing? What about the DHEA? Which tests have to be done at a hospital and do you sleep over (ex. 24 hour urine)? How would I get my doctor to test my adrenals? I was figuring I'd leave it up to the ND who I might see, since he looks at symptoms and can do bloodwork, and give all sorts of supplements.
I'm betting that part of it has to do with pressure on my nervous system, needing spinal/chiropractic adjustments and/or accupuncture.
My calcium level was checked several months ago, but I think it was the usual serum test. I recently had my RBC Magnesium checked, and it was low-normal. I've been taking magesium taurate for several weeks, and I haven't noticed any kind of improvements yet.
I was found to have a very mild Vitamin D deficiency. Some use of Vit D supplement didn't seem to do anything.
I was recently diagnosed with "Upper Airway Resistance" form of sleep apnea, with a very mild severity. I'm on a trial of CPAP, and I haven't noticed any improvements yet.
I've gone through many kinds of special food diets, including one that cut out things I tested allergic to, though they weren't causing symptoms; as well as a sugar-free diet; a candida diet (in case I had it); high vegetable diet with raw juicing; etc. They didn't seem to improve my health.
I posted my FT3 on here before, and everyone was saying my levels were right where they should be, so I began looking elsewhere. Though if the ND I'm considering seeing advises I try a thyroid product, I'll try it for sure.
What kind of tests are there for adrenal testing? What about the DHEA? Which tests have to be done at a hospital and do you sleep over (ex. 24 hour urine)? How would I get my doctor to test my adrenals? I was figuring I'd leave it up to the ND who I might see, since he looks at symptoms and can do bloodwork, and give all sorts of supplements.
I'm betting that part of it has to do with pressure on my nervous system, needing spinal/chiropractic adjustments and/or accupuncture.
My two cents worth..what about your calcium levels? Low calcium levels can make you lethargic too.
Also do you snore? Sleep apnoea is also a reason for the tiredness, etc. ( I have it and it ain't no fun on top of being super hypo!)
There is a great book out called Adrenal Fatigue The 21st Century Stress Syndrome.
Do your self a favour and see if you can get a hold of a copy. It talks about many issues, but one that sticks out for me is the food sensitivities and tiredness. I am gluten intolerant and if I happen to eat a wheat/gluten based product, I surely feel very foggy brained, tired, mood gets very grumpy.
Getting a cortisol test done is also invaluable to find out your problem.
Also do you snore? Sleep apnoea is also a reason for the tiredness, etc. ( I have it and it ain't no fun on top of being super hypo!)
There is a great book out called Adrenal Fatigue The 21st Century Stress Syndrome.
Do your self a favour and see if you can get a hold of a copy. It talks about many issues, but one that sticks out for me is the food sensitivities and tiredness. I am gluten intolerant and if I happen to eat a wheat/gluten based product, I surely feel very foggy brained, tired, mood gets very grumpy.
Getting a cortisol test done is also invaluable to find out your problem.
Your symptoms and your test results , although missing the most important test, FT3, are consistent with being hypo. As I mentioned above, the so-called normal ranges are so broad that being just within the lower limit does not assure that you are okay. In fact many of our members tell us that symptom relief for them required that FT3 was adjusted into the upper part of the range and FT4 adjusted to at least midpoint.
Whether the doctor likes to use the FT3 test or not, you should insist on it and not take no for an answer. You're the customer and the doctor is providing a service, which should be that of trying to make you feel better. I am very confident that when the FT3 test is done it will also be in the low end of the range as well and also indicative of being hypo.
This is a link to an article written by a doctor. If you give a copy to your doctor, it might provide some impetus for the doctor to change his approach. However, if the doctor is unwilling to treat you clinically (for symptoms) by testing and adjusting FT3 and FT4 with meds as required to relieve symptoms, without being constrained by resultant TSH levels, then you will need to find a good thyroid doctor that will do so.
http://www.hormonerestoration.com/Thyroid.html
To also find out about possible adrenal contribution to your symptoms, it would be best to get a cortisol test done, with multiple samples over a 24 hour period. Since patients with hypothyroidism also frequently have low Vitamin D, B12 and iron/ferritin, those would be good to check out also.
Whether the doctor likes to use the FT3 test or not, you should insist on it and not take no for an answer. You're the customer and the doctor is providing a service, which should be that of trying to make you feel better. I am very confident that when the FT3 test is done it will also be in the low end of the range as well and also indicative of being hypo.
This is a link to an article written by a doctor. If you give a copy to your doctor, it might provide some impetus for the doctor to change his approach. However, if the doctor is unwilling to treat you clinically (for symptoms) by testing and adjusting FT3 and FT4 with meds as required to relieve symptoms, without being constrained by resultant TSH levels, then you will need to find a good thyroid doctor that will do so.
http://www.hormonerestoration.com/Thyroid.html
To also find out about possible adrenal contribution to your symptoms, it would be best to get a cortisol test done, with multiple samples over a 24 hour period. Since patients with hypothyroidism also frequently have low Vitamin D, B12 and iron/ferritin, those would be good to check out also.
I had to sleep about 11 hours last night to feel with it enough to get up. This is crazy. I normally have to have a lot of sleep.
Here's the most recent:
8-21-10 Labwork
TSH 2.17 ref [0.47-4.68]
Free T4 1.13 ref [0.60-2.19]
That particular doctor doesn't like to use the Free T3 test. I figure there is something going on with my nervous system and possibly adrenals, causing all the ADHD, fatigue, poor stress resistance, nervous-habits, etc.
Older results:
http://www.medhelp.org/posts/Thyroid-Disorders/New-thyroid-labwork/show/1193153
8-21-10 Labwork
TSH 2.17 ref [0.47-4.68]
Free T4 1.13 ref [0.60-2.19]
That particular doctor doesn't like to use the Free T3 test. I figure there is something going on with my nervous system and possibly adrenals, causing all the ADHD, fatigue, poor stress resistance, nervous-habits, etc.
Older results:
http://www.medhelp.org/posts/Thyroid-Disorders/New-thyroid-labwork/show/1193153
The so-called normal ranges are so broad that being just within the lower limit does not assure that you are okay. In fact many of our members tell us that symptom relief for them required that FT3 was adjusted into the upper part of the range and FT4 adjusted to at least midpoint. I was not ignoring your concern about the adrenals. I just think we should start with a look at the actual results of the thyroid tests that you have, and their reference ranges shown on the lab report.
My TSH, Free T3 and Free T4 were all in normal range. I also had normal antibodies. My TSH and FT4 was checked within a month or so, and I believe that was normal.
Results:
http://www.medhelp.org/posts/Thyroid-Disorders/New-lab-results-from-4-13-10/show/1230498
Does anyone here know about adrenal exhaustion?
Results:
http://www.medhelp.org/posts/Thyroid-Disorders/New-lab-results-from-4-13-10/show/1230498
Does anyone here know about adrenal exhaustion?
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